Shake-up planned for immunisation programme
Patients wrongly diagnosed with epilepsy are costing the NHS millions of pounds in care and prescriptions, new research reveals.
The study estimated there were some 92,000 patients misdiagnosed with epilepsy every year in the UK.
The average medical cost per misdiagnosed patient was £263, of which 10 per cent related to GP care and 24 per cent to inappropriate prescribing of anti-epileptic drugs, the research showed.
This relates to a total cost burden on GPs of around £8.2 million.
The study authors, who presented the findings at the Society for Academic Primary Care conference in Gateshead earlier this month, could not pinpoint where the misdiagnoses occurred.
But epilepsy experts said one reason for the high cost of inappropriate prescriptions could be that problems with access to epilepsy specialists had forced some GPs to start prescribing anti-epileptics until the diagnosis could be confirmed.
Study leader Dr Tim Stokes, senior lecturer in general practice at the University of Leicester and a GP in the city, said the study highlighted the high cost to the NHS of a misdiagnosis.
Dr Stokes, clinical director of the National Collaborating Centre for Primary Care, added: 'The study provides further evidence about the need for all practitioners in primary and secondary care, if they see someone with a new onset suspected seizure, they need to refer them to a specialist to get the right diagnosis. If they are not there is a significant risk they will not get the right diagnosis.'
But Dr Henry Smithson, chair of the NICE epilepsies guideline development group and a GP in Escrick, North Yorkshire, said there were real issues with access to specialists and added the various different epilepsies were difficult to diagnose because of the range of symptoms.
He added: 'Diagnosis should be established by a specialist with an interest and expertise in epilepsy but they are in short supply.'
By Nerys Hairon
·Be aware of the high misdiagnosis rate by specialists
·Refer all possible new cases to a specialist with expertise
·Consider the possibility of a wrong diagnosis if the story seems inconsistent or if 'seizure' control is not achieved with appropriate first-line drugs
·Try to get an early and complete patient history and eye-witness accounts
·Question inconsistent classification of a patient's epilepsy in hospital letters
Source: Dr Henry Smithson, NICE epilepsy guidelines, and Professor Azeem Majeed, professor of general practice at
Imperial College London